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ELIZABETH A. NEVILLEydTown Hall, 53095 Main Road
TOWN CLERK • P.O. Box 1179
Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
F � Fax(631) 765-6145
MARRIAGE OFFICER �` y,/� ��
RECORDS MANAGEMENT OFFICER __�Ql * ,601 Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2363 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ZOUMAS CONTRACTING CORP
Address 1 : PO BOX 361
City St Zip WADING RIVER NY 11792
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-00-0113
Name Of Owner DOROSKI, VERA D
Mailing Address 1 1061 OLD COUNTRY ROAD, #145
City St Zip RIVERHEAD NY 11901
Property Address 1 BEBEE DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 97.00 block 7 lot 14.000
Cross Street DEERFOOT PATH
Building Permit Number Cross Reference:
Issue Date: 7/12/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE t/_0 *d\ Town Hall, 53095 Main Road
TOWN CLERK t 0 - P.O. Box 1179
% CA
Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS � Q
MARRIAGE OFFICER `� 1�i1. ���I', Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = Weljig �a0'i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .---- .....0'..9."
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 10, 2000
Transmitted herewith is a copy of application No. 2451 for a Cesspool/Septic Tank Construction
Permit submitted by:
Zoumas Contracting Corp. For V. Doroski
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations: /
APPROVE
DISAPPROVE
Comments:
Slgnature
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Dated
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OFFICE OF THE TOWN CLERK •••• f OL
TOWN OF SOUTHOLD 1.4. °0 e.Qy Application No. g7y5 1
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 iOss
Construction
SOUTHOLD,NEW YORK 11971o rn
Alteration
crs yc
Telephone 0,0 �i rI ' $10.00 -Residential -Vr
(516) 765-1801 �l �,•o•• $25.00 -Non-Residential
• -- .....0,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
RECEIVED
APPLICATION
JUL 1 0 2000
for
Anhold Town Clerk
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 742A7
APPLICANT NAME: 2OUMAS.CONTRACTINC CORP.
APPLICANT ADDRESS: `''r11.P•O:Box 361
Wading Rater, NY 11792
SEPTIC CESSPOOL
/6 TION OF PRO OSED CONSTRU ION OR ALTERATION
FA-,+r1 t 7 406v r h
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERA-ION:
OWNER OF PROPERTY: V(-AA b r 1)0 (10 -/
OWNER MAILING ADDRESS: /b6/ tai..- Ga/v77 i�
MoE3tc_ t once, l yc A 0.eA 442_40 A)• y_ I/ 9o/
OWNER PROPERTY ADDRESS: Qe, eSib c/Q.>
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TELEPHONE NUMBER OF CONTACT PERSON: g019-4/570
TAX MAP NO. : Section 97 Block 7 Lotici rr„_,_., T
CROSS STREET: ro07' Ph----r*
BUILDING PERMIT NUMBER CROSS REFERENCE:
• -ture k. ._ .
E1)
RECEIVED BY:
Town Clerk's Office
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DATE: I (11►6 •
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tTR11CTURIS TO THE'PROPERTY FOR WHOM THE�SU�RVEY IS PM •
SURVEYED FOR
. '`La',/:'k`�1 FOR A LOT NUMBER 15 r 44;�
Avg, oP� ,i 14iIL • & ; ,. . ;,4'� `e Y To MAP OF MOOSE COVE r ,%,.';,1-
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- MAUS, •• A .,• •THE ASSIGNEE •Iq�T�HE L'ENDINC •2 ,
q',,'.- • r^ 1 R...+47 $ ,� T .414.:
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• •5 ITERATION.OR . '`..\ ,
AOIATION OF :. •' ••,.T,, • ,, - TOWN OF SOUTHOLD, S J *• z ,, NEW YORK•
` RTR r. liUMMIRE1 • s „ s. , . t
�;� 1 •1! �; =1 , •.EAI SCALE 1" = 40'. .atilt,.` 4,. .17 -.20'x.
SHNi • SE CONSIDERED TO 8t
'` EXPIRES THREE YEARS PROM DATE OP APR?OVA C FILED MAP NO.
V'eARANTEED ONLY To 3230 P4TE 8 30 - 1960
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TAX MAP NO. K ING? - 97 a': •(REF ONLY)DISK 21,
'ZOIJMAS CONTRACTING CORR.
r ;UPRISE ABSTRACT CORP. HAROLD F. 'TBANCIHON. ,IR. P.C. -
Ai i` • LAND SURVEYOR
►'-c' 1866 WADING RIVER-MANOR RD. WADING;RIVER,
l';'11::'- NEW YORK, 1 1.792 fx
/R LIC. NO. 048992 5 1.6-929-469 ,.
' r;giminalQN .IR.' PENN. LIC.' NO. 21115-E
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